and answers 100 solved

Woo & Robinson Chapter 11 Question and answers 100% solved Which adverse drug reaction to a selective alpha1 agonist would be the best reason to change to a different class of medication?

• Chronic pain with use of NSAIDs
• Rhinitis
• Drowsiness
• Impotence - correct answer 4. Impotence

Option 4:

The leading cause of nonadherence to a treatment regimen with alpha1-adrenergic antagonists is inhibition of ejaculation and impotence. These reactions should be reported to the health-care provider, who may choose a different drug to treat the disorder or change the dosage.Rationales

Option 1:

Use of NSAIDs will lead to possible reduction in the antihypertensive effects of this class, not to chronic pain.

Option 2:

Rhinitis may occur, which should not be treated with over-the-counter (OTC) antihistamines or other cold remedies without first consulting with the health-care provider. However, this is not the best reason to change to a different class of medication.

Option 3:

Drowsiness is common with this class of drug. It will pass within 7 to 10 days.Which known adverse reaction to a cholinergic blocker would be considered most problematic?

1.Exacerbation of Parkinson's disease 2.Urinary incontinence 3.Decreased gastric acid secretion 4.Decreased sweating - correct answer 4. Decreased sweating

Option 4:

Decreased sweating can put patients at risk for hyperthermia during warmer months and strenuous activity.Rationales

Option 1:

Cholinergic blockers are useful adjuncts for early management of Parkinson's disease. 1 / 3

Option 2:

Urinary hesitancy and urinary retention, not urinary incontinence, are known adverse reactions to cholinergic blockers.

Option 3:

Reduction of acid leads to increased nausea, decreased appetite, and slower motility.This is a known adverse reaction to cholinergic blockers, but it is not the most problematic.Which of the four main receptor types is primarily associated with stimulation of adenylyl cyclase and is found mostly in the heart?

1.Alpha1 2.Alpha2 3.Beta1 4.Beta2 - correct answer 3. Beta1

Option 3:

Beta1 receptors, found mostly in the heart, brain, kidney, and lipocytes, are associated with stimulation of adenylyl cyclase via G5-G-protein-coupled receptors to increase cyclic adenosine monophosphate (cAMP) production.Rationals

Option 1:

Alpha1 receptors are mostly associated with excitation or stimulation and are found mainly in the eyes, salivary glands, arterioles, postcapillary venules, and gastrointestinal (GI) and genitourinary (GU) sphincters.

Option 2:

Alpha2 receptors are mostly associated with relaxation or inhibition of norepinephrine (NE) release, and most are located in the presynaptic nerve terminals of smooth muscles, the islet cells of the pancreas, salivary glands, skin, and mucosa.

Option 4:

Beta2 receptors are located in the smooth muscle of the eyes, arterioles, venules, bronchioles, liver, pancreas, and gastrointestinal (GI) and genitourinary (GU) systems.Bethanechol is contraindicated in the presence of which disease?

1.Peptic ulcer disease 2.Hypothyroidism 3.Preexisting hypertension 4.Glaucoma - correct answer 1. Peptic ulcer disease

Option 1: 2 / 3

Bethanechol can cause excessive secretion of gastric acid, which could intensify gastric erosion and precipitate gastric bleeding and possible perforation.Rationales

Option 2:

Bethanechol is contraindicated in patients with hyperthyroidism, not hypothyroidism.

Option 3:

Bethanechol is contraindicated for patients with preexisting hypotension, not hypertension.

Option 4:

Muscarinic agonists, such as bethanechol, are used clinically to treat glaucoma.The pharmacodynamics of selective alpha1 antagonists prevents them from being frontline treatment of hypertension. Which of these is the best reason to limit the use of selective alpha1 antagonists for treating hypertension?

• Reflex tachycardia
• Orthostatic hypotension
• Rebound hypertension
• Fluid retention - correct answer 4. Fluid retention

Option 4:

All the "azosin" drugs are contraindicated in the presence of volume depletion.Peripheral vasodilation caused by these drugs decreases venous return to the heart and may precipitate significant heart failure (HF). Several of the drugs are associated with fluid retention that may exacerbate HF.Rationals

Option 1:

Reflex tachycardia may result from compensatory mechanisms but is minimal. It is not the most likely reason to limit the use of selective alpha1 agonists for treating hypertension.

Option 2:

The possible drop in blood pressure, especially within the diastolic parameters, could have potential for adverse reaction to initial use. However, it is not the best reason to limit the use of these drugs for treating hypertension.

Option 3:

With possible activation of receptors, the opposite effect and subsequent increase in blood pressure could be problematic. However, it is not the best reason to limit the use of these drugs for treating hypertension.Activation of central alpha2 receptors results in inhibition of cardioacceleration and vasoconstriction centers in the brain. This action causes a decrease in peripheral outflow of norepinephrine (NE), leading to which effect?

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